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Concussion-Related CTE Possible in Veterans

After master gunner Shane Garcie completed his final tour in Iraq, it took him around six weeks to notice something about him was different. “Your brain is throwing parties because you’re home, you’re alive,” Garcie said. “So, it doesn’t settle in right away.”

Garcie is unsure which issue is bothering him the most: a foggy brain or the erratic anger and depression he faces. He stated, “one minute I’m in a good happy mood, everything is cool; the next minute I’m depressed.” He is also unable to recall how many concussions he had during his time in the service.

Another service member, Green Beret Tommy Shoemaker, who is still an army reservist, is also experiencing issues day to day due to a disabled brain.

“I carry note cards and a pen with me everywhere I go, and when I’m talking to somebody, I write it down, because if I don’t, I won’t remember. I mean memory was not a problem for me, I could remember anything. And now I have to write everything down,” Shoemaker reported.

The mood swings have turned out to be the most difficult obstacle to overcome. “I’ve always been really easygoing. Everything rolled off my back, no problems […] But now that’s not so,” claims Shoemaker.

According to the Brain Trauma Foundation, 10% to 20% of Iraq veterans are experiencing some level of a traumatic brain disorder. It is even called “the signature injury” of the Iraq and Afghanistan wars.

CTE, or chronic traumatic encephalopathy, is a neurological disorder that is caused by repeated trauma to the head. CTE is distinguished by deep depressions, faulty memory, anger, and is also a form of dementia that first came forth in the boxing world. Former boxers, such as Muhammad Ali, have experienced significant brain damage after a long career of hard blows to the head. The term “punch drunk” is now called dementia pugilistica and is considered a different form of CTE. This disorder has also believed to have played a role in the deaths of a handful of former NFL players.

Imaging for CTE is usually performed on brain samples collected during an autopsy, which has been the only way to diagnose CTE. Some studies have examined living brains in hopes that a diagnosis could be found prior to death.

Dr. Geoffrey Ling informed that, “looking at living brains is a remarkable contribution to the science right now, a really remarkable contribution. It is very exciting and the potential is dramatic.” Dr. Ling is the director of the Biological Technologies office at DARPA, the Defense Advanced Research Projects Agency.

Dr. Julian Bailes, who is the co-director of the NorthShore Neurological Institute in Evanston, IL, and co-authors at UCLA compared the living brains of 14 former athletes suspected of having CTE, 24 patients with Alzheimer’s, and the two veterans mentioned above to 28 “cognitively normal people.” This is one of the largest studies of it’s kind.

The test included researchers injecting the participants with a “tracer” called [f-18]FDDNP before they underwent PET scans. This tracer attaches to a brain protein called tau, which is believed to be responsible for damage in Alzheimer’s and other degenerative brain disorders, and then “lights” up areas of the brain that are impacted.

“For us to be able to make the diagnosis of the injury or the disease in living people is paramount to being able to help them, treat them and to find some way to keep them out of progressing into a terminal problem,” claims Dr. Bailes.

The brain scans of the veterans were an added bonus and a sample made to give a look into what could be causing their symptoms. It gives a chance for experts to explore the theory that blasts and jolts from warfare could be causing a new, “blast-variant” form of CTE.

“In the military, it seems it would be vitally important to know who has been exposed to this, and then be able to identify, mark, follow the progression of brain degeneration from blast injury,” Bailes said. “And to know who’s at risk and maybe who needs to be pulled out of harm’s way permanently.”

The specific pattern of the tau that researchers found in Garcie and Shoemaker’s brain was not similar to Alzheimer’s. It instead looked more like the tau display presented in the 14 athletes CTE results and the results from brain autopsies confirmed with CTE.

Despite recent research, the science behind Chronic Traumatic Encephalopathy is still in it’s early stages. Researchers from all over the country have been trying to gather as much information to figure out if CTE is prominent enough to be diagnosed, and if it is truly a “new” neurodegenerative disease. Dr. Ling claims that more in depth research needs to be done for this condition.

Dr. Ling states, “In the end, these scans are just scans. That’s all that they are. It really has to do with the context of the patient. We have to understand the patient: What is their history? Do they have multiple head injuries? Do they have anything else that could compound this?”

At this point in time, there is no cure for CTE, only different ways to help treat symptoms. This is often done with therapy and prescriptions for antidepressants to help with anger and anxiety. Dr. Bailes highlights the importance of taking people out of harm’s way if they have already experienced a brain injury and giving them time for their brain to heal.
Experts say that identifying brain trauma at the moment of the injury is extremely significant. Several tests are currently being developed that will hopefully be able to diagnose brain trauma in war zones or on the sidelines of a football game when the injury is acquired.

Veteran Tommy Shoemaker believes it’s important that soldiers receive a physical diagnosis and not just a mental one. As for Shane Garcie, he hopes no other soldiers will have to endure what he has been through.

“But it’s not just Shane that’s having all these brain issues. There were thousands of troops who were getting blasted by IEDs, car bombs, RPGs, grenades. I want them to know that they’re not alone.”

The Archuleta Law Firm handles injury, death, and veterans medical malpractice claims under the Federal Tort Claims Act. We handle claims in all 50 States and Worldwide. Our focus is helping Veterans, and the families of Veterans and Military Service Members in their claims involving Veterans (VA) Hospitals, Doctors and Clinics and Military Hospitals, Doctors and Clinics. We handle claims involving the Department of Veterans Affairs, the U.S. Army, the U.S. Navy, and the U.S. Air Force.